AB1185 PATIENT-REPORTED EXPERIENCE IN IMMUNE MEDIATED INFLAMMATORY DISEASES (IMID) IN THECONTEXT OF THE COVID-19 PANDEMIC: ACCESSIBILITY AND CONTINUITY OF CARE.
Authors: J. P. Baldivieso, E. Ramirez, M. Uriarte-Ecenarro, C. Valero, E. Velasco, I. Llorente, A. Morell, O. Solas, R. Garcia-Vicuna
Journal: Annals of the Rheumatic Diseases (2022)

Background The lockdown and mobility restrictions in early COVID19 pandemic had a great impact in chronic patient care due to limited access and scheduled visits. In our hospital, coordinated non-pharmacological interventions (NPI) were designed in Rheumatology and Pharmacy services to maintain the accessibility and continuity of care for patients with IMID. Objectives To evaluate the patient reported experience (PRE), health status and quality of life in Rheumatology outpatient IMID subjects since March 14, 2020 when lockdown was imposed and during subsequent restrictions, related to the healthcare team and medications accessibility, and continuity of care. Methods Observational study, using a patient survey. Adult patients attending the rheumatology outpatient clinic between Nov 2, 2020 to Feb 13, 2021, with rheumatoid arthritis (RA), psoriatic arthritis (PsA), spondylarthritis (SpA) or systemic autoimmune diseases (SAD), with at least 1 year from diagnosis and 1 month of treatment with conventional synthetic (cs) targeted synthetic (ts) or biological (b) disease modifying antirheumatic drugs (DMARD). Face to face or phone interviews were conducted using an ad hoc designed questionnaire that included COVID19 related questions, the 11 IEXPAC scale items (5 point Likert scale ranging from never to always) ( www.iexpac.org ), and 4 items (5 points, very good to very bad) of the global scale PROMIS 10 (Patient-Reported Outcomes, PRO). All questions refer to the patient’s experience during the 6 months prior to data collection. Results From 174 screening patients, 158 completed the survey, mainly woman (66.5%) with a median age of 60 (IQR 47-69,3) years. The most frequent diagnosis was RA (43%) followed by ESAP (35%), EAS (22%) and PsA (13%). 46.8% of the patients have been prescribed b or ts DMARD and 53.2% sc DMARD, 32.9% in combination. From 158, 39 persons requested healthcare for COVID-19 related symptoms and diagnosis was confirmed in 17 (10,8%). Just 2 patients required hospital admission. Clinical control and continuity of care for COVID19+ patients were carried out from their primary care center and by phone consultation. Some key results of the survey are displayed in Table 1. Table 1. PRO and Patients’ perception during COVID19 lockdown and restrictions. During confinement and restrictions due to covid-19, in the last 6 months … Responses (% ) N= 158 Your degree of concern about the COVID19 crisis is. High + Quite high (86.7) PRO (PROMIS 10 ) How good was your health …? Very good (11.4), Good: (43.7) and your emotional/mental health, including mood and ability to think? Very good (10.1) Good (41.1) your quality of life was. Very good (8.25) Good (49,4) Your satisfaction in performing daily tasks (home, work, family) was. Very good (7.8) Good (55.1) Accessibility to care and medications I could contact my rheumatologist whenever I needed (email, phone). Always (79.9) My rheumatologist changed my face-to-face visit for a phone call Yes (53) I received my medication at home from the hospital pharmacy Yes (16) I picked up my medication from the hospital pharmacy, without incident. Yes (21) I maintained the prescribed dose medication… Always + almost always (96,2) At some point I modify a medication by my own decision Yes (6) My doctor changed the dose or route of administration Yes (7) Your satisfaction with the care provided from all professionals in the team was Very + Quite satisfied (75) PREMS (IEXPAC ) Item 2. The professionals … are coordinated to offer me good healthcare Always (34.18) Item 8. They make sure that I take my medication correctly Always (73.42) Item 9. They worry about my welfare Always (74.68) Conclusion Lessons have learned during the COVID19 lockdown and restrictions by assessing patients’ health status and patients-reported experience. Coordinated NPI such as medication monitoring and home delivery, appointment reorganization and protocolized phone visits can result in a good patient perception and medication adherence whilst receiving care in a challenging situation. Disclosure of Interests None declared